J Perinatol

. 2024 Jun 28.

 doi: 10.1038/s41372-024-02024-z. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/38942929/

Association between initial ventilation mode and hospital outcomes for severe congenital diaphragmatic hernia

K Taylor Wild ¹, Leny Mathew ², Anne M Ades ³, Natalie E Rintoul ³, Leane Soorikian ³, Kelle Matthews ³, Sura Lee ³, K Taylor Van Hoose ⁴, Erin Kesler ⁴, Sabrina Flohr ², Anna Bostwick ², Tom Reynolds ², Holly L Hedrick ^2 4, Elizabeth E Foglia ³

Affiliations expand

• PMID: 38942929
• DOI: 10.1038/s41372-024-02024-z

Abstract

Objective: To determine the association between initial delivery room (DR) ventilator (conventional mechanical ventilation [CMV] versus high frequency oscillatory ventilation [HFOV] and hospital outcomes for infants with severe congenital diaphragmatic hernia (CDH).

Study design: Quasi-experimental design before/after introducing a clinical protocol promoting HFOV. The primary outcome was first blood gas parameters. Secondary outcomes included serial blood gas assessments, ECMO, survival, duration of ventilation, and length of hospitalization.

Results: First pH and CO₂ were more favorable in the HFOV group (n = 75) than CMV group (n = 85), median (interquartile range (IQR)) pH 7.18 (7.03, 7.24) vs. 7.05 (6.93, 7.17), adjusted p-value < 0.001; median CO₂ 62.0 (46.0, 82.0) vs 85.9 (59.0, 103.0), adjusted p-value < 0.001. ECMO, survival, duration of ventilation, and length of hospitalization did not differ between groups in adjusted analysis.

Conclusion: Among infants with severe CDH, initial DR HFOV was associated with improved early gas exchange with no adverse differences in hospital outcomes.

© 2024. The Author(s).